I was forwarded the below email/blog reply from a member, who requested I post it in a visible area of the forum. The member contacted Dr. Alan Jacobs, a neuroendocrinologist in NYC, regarding brain fog/cognitive issues.
Below is Dr. Jacobs’ reply, from blog.alanjacobsmd.com/alan-jacob … l#comments
His website is neuroendocrinology.org/index.html
"I have experience with several men who have developed a “brain fog”-syndrome on Propecia. This has often been associated with increased stress and anxiety.
I wonder if the neuroendocrine link is via the blocking in some men of their brain’s 5-alpha-reductase enzyme (Type 1 isoform), even though it is supposed to block only the Type 2 isoform, leading to a reduction in the conversion of progesterone to allopregnanolone, a potent anxiety-reducing agonist of the brain’s GABA-A receptor. This decrease in allopreganolone is associated with increased anxiety, which can secondarily cloud attention and concentration.
Since there are reports of permanent sexual dysfunction upon stopping fenasteride (Swedish package insert for Propecia 1mg) it is not a stretch to consider other brain-based permanent effects.
I wonder if progesterone would help. I have recently seen progesterone given to men intravenously after severe head trauma with great benefit, which I realize is a very different setting. However, this was the first setting I have seen giving progesterone to men with success."
- Dr Jacobs